Taking NyQuil With Ambien - Interaction Details
In our latest question and answer, the pharmacist discusses the safety of combining NyQuil and Ambien (zolpidem).
I occasionally take Ambien, but only when I really need help sleeping. I want to know if NyQuil is safe to take if I already took an Ambien.
Apr 07, 2023- Ambien and NyQuil should not be taken together because both have sedative effects that can dangerously increase drowsiness and impair your ability to drive safely. If you need cold or flu relief while taking Ambien, choose non-sedating options like acetaminophen, dextromethorphan, phenylephrine, or guaifenesin instead. Talk to your doctor or pharmacist before combining any sleep medications with over-the-counter products.
Answer
In general, Ambien (zolpidem) should not be combined with other drugs that have a CNS (central nervous system) depressant effect. Since NyQuil contains doxylamine, a sedating antihistamine, it's recommended not to take it alongside Ambien.
Additional Interaction Details
As Ambien has strong sedative effects, its use with other medications that have a similar effect is not recommended. Per the prescribing information for Ambien:
AMBIEN, like other sedative-hypnotic drugs, has central nervous system (CNS) depressant effects. Co-administration with other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol) increases the risk of CNS depression. Dosage adjustments of AMBIEN and of other concomitant CNS depressants may be necessary when AMBIEN is administered with such agents because of the potentially additive effects. The use of AMBIEN with other sedative-hypnotics (including other zolpidem products) at bedtime or the middle of the night is not recommended.
Combining Ambien with other CNS depressants has been linked to increased psychomotor impairment, impaired driving abilities the next day, and a higher risk of other potentially dangerous behaviors, like sleep-driving.
NyQuil contains the following ingredients:
- Acetaminophen
- Dextromethorphan
- Doxylamine
NyQuil Severe adds in the nasal decongestant, phenylephrine.
It is the doxylamine in NyQuil that interacts with Ambien.
Doxylamine is a sedating, first-generation antihistamine, very similar to diphenhydramine (the active ingredient in Benadryl).
On its own, doxylamine has fairly strong sedative effects, and when combined with a drug like Ambien, those effects are potentiated.
How To Manage The Interaction
It is generally recommended to simply avoid taking Ambien and NyQuil together due to their additive sedative effects.
If you are looking for something to take to help alleviate the symptoms of a cold/flu, you can find several over-the-counter options that are not sedating and do not interact with Ambien.
These options include:
- Acetaminophen (pain reliever)
- Dextromethorphan (cough suppressant)
- Phenylephrine (nasal decongestant)
- Guaifenesin (expectorant)
All of the above are commonly used for symptom relief and are perfectly safe to take with Ambien. An issue arises when any of these ingredients are combined with a sedating ingredient (like doxylamine).
Final Words
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Glossary — Terms in This Answer
- CNS depressant
- A medication or substance that slows down brain and nervous system activity, reducing alertness and causing drowsiness.
- Sedative-hypnotic
- A class of drugs designed to calm the nervous system and promote sleep.
- Antihistamine
- A medication that blocks histamine, a chemical in the body that causes allergic reactions and promotes wakefulness.
- Psychomotor impairment
- A reduction in the ability to coordinate movements and react quickly, affecting physical coordination and response time.
- Potentiated
- Strengthened or intensified, especially when the combined effect of two substances is greater than each would have alone.
- Dextromethorphan
- A cough suppressant ingredient commonly found in over-the-counter cold and flu medications.
- Guaifenesin
- An expectorant that helps thin mucus to make coughs more productive and easier to manage.
- Concomitant
- Occurring or used at the same time as something else.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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